VA-BC Device Selection & Insertion Techniques 5

Question 1

A patient needs TPN with an osmolarity of 1,500 mOsm/L. Which access device is appropriate?

Accepted Answer

Central venous access device

Answer

Solutions exceeding 900 mOsm/L must be administered through a central venous access device to prevent peripheral vein damage.

Question 2

Intraosseous (IO) access is most appropriate in which situation?

Accepted Answer

Emergency when IV access cannot be rapidly established

Answer

IO access provides rapid vascular access to the bone marrow cavity during emergencies when conventional IV access fails.

Question 3

Which of the following is a contraindication to basilic vein PICC insertion?

Accepted Answer

History of DVT in the ipsilateral upper extremity

Answer

Previous DVT in the ipsilateral extremity contraindicates PICC insertion in that arm due to high risk of rethrombosis and vessel compromise.

Question 4

What is the recommended maximum dwell time for a peripheral IV catheter in adults, absent complications?

Accepted Answer

72–96 hours

Answer

CDC guidelines recommend rotating peripheral IV sites every 72–96 hours in adults unless clinical indication requires earlier removal.

Question 5

During ultrasound-guided PICC insertion, the 'dynamic needle tip positioning' (DNTP) technique aims to:

Accepted Answer

Continuously visualize the needle tip throughout vessel entry

Answer

DNTP keeps the needle tip continuously in view on ultrasound during advancement, reducing risk of posterior wall puncture.

(VA-BC) Vascular Access Nurse Certification Practice Test